Summer’s here: Thoughts turn to feeding the kids in the holidays.

London looks good when the sun’s out. But a holiday, or even a day or two at the seaside is an impossible dream for a growing number of young families. A study published today shows that Britain will have 3.5 million children living in poverty by 2020. Another report released today by charities Oxfam, Church Action on Poverty and the Trussell Trust reveals that more than 20 million meals were provided to people in the UK last year – a breathtaking 54% rise on the previous year.

Holiday plans get pushed much further down the list when you’ve got a number of young mouths to feed and no money to do it with. Tonight, the terrible situation faced by growing numbers of youngsters whose parents are struggling to put together the money for their meals will be shown in a Channel 4 documentary called Breadline Kids. It’s on at 7.35pm. One mum on benefits mentioned in the programme has £3.60 a day to spend on herself and her two daughters. This figure seems to tie in with the one given to me by a number of single adults I’ve met at the London food bank. A number of them had been attempting to feed themselves on a budget of £2 a day – or sometimes less.

The accounts of the children are very touching, but hard to listen to. Since the recession began over 1,000 breakfast clubs have been started for primary school children. The problem of children arriving at school hungry has been growing significantly over the last two years. When schools are out for six weeks this summer, children will suffer even more, as the hardest-pressed family budgets melt down to nothing.

Ray Woolford runs the We Care advice centre in South-East London, which provides help and support to struggling individuals and families. The centre also sells fresh and long-life food at very low cost to those in need. He is very concerned about what will happen to families with school-aged children this summer. ‘More and more people are saying they are terrified about how they are going to feed their children.’

He’s currently trying to come up with a solution in time for the mass exodus when schools break locally: ‘We’re trying to find kitchens so that we can run breakfasts and lunch clubs. If not, then we will have food parcels for people to take, with milk and cereals. If we can’t get kitchens then we will create summer kitchen packs.’ He’s also considering liaising with local cafes.

In Blackpool, breakfasts are now being offered to all primary school children. Increasingly, local communities will start to become more aware of the scale of the summer destitution on their doorsteps. I’ve just heard of the case of parents with an 11-year-old daughter who’ve all just spent a week sleeping in a London park. These dreadful cases won’t and can’t remain hidden much longer.

Can England’s A&E units spot the malnourished? Mark’s story revisited

Can England’s A&E units spot the malnourished? Mark’s story revisited
Mark Bothwell, who's on jobseeker's allowance. He says he hasn't been eating properly for years.
Mark Bothwell, who’s on jobseeker’s allowance (JSA). He says he hasn’t been eating properly for years.

Mark Bothwell (above) came into the London food bank today. He’s had a painful problem with his shoulder for some time that leaves him unable to accept many types of physical work, and he also has depression. He’s been waiting for months for his claim for employment and support allowance (ESA) to be processed. Not that this 29-year-old is likely to be better off financially by transferring over from JSA, but he would at least be relieved of  some stress. He says: ‘It’s a job-stopping illness, so the positive thing (about changing benefits) is not having to worry about job hunting.’

Last week, he described two recent trips to the accident and emergency (A&E) unit at the local hospital – the Queen Elizabeth in Woolwich. He says that terrible chest pain drove him to seek help, and that a viral infection causing inflammation of the outer lining of the heart was suspected. Mark, who is already on strong medication prescribed by his GP for his shoulder pain, had an adverse reaction to one of the medications given at the A&E. It upset his stomach and caused ‘a lot more pain’. This extra pain meant he had to make a second visit to A&E later that week. While the doctors took a family history during his visits to cover heart issues, and did blood tests, an ECG and X rays, he says the doctors didn’t ask about his circumstances. ‘They didn’t ask if I’d been eating properly for the last few months. Actually, I’ve not been eating properly on and off for years. Money has come and gone for years since I moved out of the house at 21. I was homeless for 18 months. Although I’ve had the foodbank vouchers, which has been good – it’s not been enough to cover the last four months. Even during this time (when he’s had some help from food vouchers) there have been a couple of days when I’ve not been able to take my pills because I haven’t had enough food.’ He says that recently, when he hasn’t had enough food, ‘shoplifting has crossed my mind, and this is how desperate people can get’.

Why didn’t  the doctors in A&E ask him about his circumstances, which may have flagged up the effect poor nutrition for many years could be having on his health? Could it be because the A&E unit, like many in the NHS in England, is understaffed and generally in crisis? The hospital is part of the Lewisham and Greenwich NHS trust, and this week health inspectors the Care Quality Commission published a report that was highly critical of many aspects of services at the trust, which it says requires improvement. The A &E unit at the Queen Elizabeth is deemed to be inadequate, and ‘not fit for purpose’. The inspectors, who visited the hospital in February, have serious concerns about the safety of A&E services there . They note a shortage of beds for admission to the hospital, causing a block in the system, particularly for patients in A&E. Ambulance personnel told inspectors there were regular delays in booking patients in and patients often had to be treated in the back of ambulances. They also pointed to the low staffing levels in A&E, with 29 full-time equivalent nurse vacancies and vacancies for four consultants and six junior doctors. The report also says that since the closure of the accident department at the nearby Queen Mary’s Hospital  in 2012, attendances had risen from around 300 to over 450 a day. Because of a lack of space, patients who ‘would have benefited from being able to lie on a trolley or bed were having their treatment on a chair in full view of other people’. Against this background, do the A&E staff  have the time to take detailed enough case histories?

Mark’s  food budget of about £2 a day and spells without eating adequately over many years must be impacting on his health, yet none of the doctors treating him in hospital asked him about his nutrition.  Is the NHS really capturing the facts about how many people are becoming ill, or having their health conditions made worse because of malnutrition and food poverty? The steep upward trend in the number of people being driven to use food banks indicates a rise in the number of individuals and families struggling to eat well. But as the Faculty of Public Health so clearly points out, actual food bank numbers are ‘an inadequate indicator of need, because many households only ask for emergency food help as a last resort’. So the true scale of food poverty remains hidden.

In Wales, hundreds of patients have been diagnosed with malnutrition in the past few years. New figures from a Freedom of Information Act request show 1,229 patients have been diagnosed since 2007/08. In England, primary and secondary diagnoses of malnutrition in hospitals rose from 3,161 in 2008/09 to 5,499 last year, according to figures released by health minister Norman Lamb. In November 2013 an early-day motion in the House of Commons from MP George Galloway noted a ‘doubling of the diagnoses of primary and secondary malnutrition in Bradford Teaching Hospitals NHS Foundation Trust in the years 2010 to 2013 compared to 2008 to 2010’.

Are all cases of malnutrition as a primary or secondary diagnosis being clearly identified, given the levels of understaffing and the workloads in some A&E units?  What information is being gathered by GPs? These are issues the All=Party Parliamentary Group on Hunger and Food Poverty may want to start examining closely during its inquiry.

The outlook for Mark this weekend is more positive, and he didn’t need a food voucher this week. His MRI results show a frozen shoulder, and he’ll be referred for physiotherapy by his GP.  Mark is relieved that he doesn’t need surgery, and he’s been told he should receive a letter within 10 days telling him when he’ll start receiving ESA payments. He’s finally got an appointment to access  group pain management talking therapy, which will take place once a week for 10 weeks. The depression is still there, but is ‘starting to feel a lot better’.

Will Peter and Sue get added to this year’s malnutrition statistics?

Is the government rushing to close down the few remaining sources of help for people like Peter and Sue (not their real names), a couple who came into the London food bank last week? Both of them have serious health issues and their sickness benefits have been delayed.

Yesterday, the story broke that the £347m hardship fund, a potential safety net for the couple, is being scrapped. The Local Government Association (LGA) is calling for ministers to review the decision. The LGA says its abolition could leave councils unable to support families who face a crisis. The loss of the Local Welfare Assistance Fund would leave councils having to find money for this from their overall budgets. The government is reported as saying that councils will continue to give support to those in financial difficulties, but the LGA has highlighted that overall funding for local government has been cut by more than 40 per cent over the course of this parliament. Doing away with this fund could leave some areas unable to afford to help out people in crisis.

This development is not going to make life any easier for Peter and Sue, who usually get employment and support allowance (ESA), but had no way of feeding themselves last week. Peter, who is bipolar, had sent the sick note that he hopes would have triggered a renewal of ESA to an office in Ireland, but believes it’s been lost in the post. Before he can start receiving ESA again, he has to repeat the process of getting his key mental health worker to arrange an appointment with his psychiatrist. It’s easy to see that this is all going to take a while to sort. Sue, who is epileptic, had been friends with Peter for many years before they became a couple. They got together after she broke up with her ex-husband, who had been violent towards her. She doesn’t seem to know why her ESA has been delayed.

Both of them have older children from their previous relationships, and now Sue, 36, thinks she may be pregnant. The couple, who are clearly devoted to each other, are living together. Sue receives housing benefit and disability living allowance (DLA) in addition to ESA. With both sets of ESA now on hold, they are trying and failing to survive on Sue’s DLA of £41 a week. That sum has to cover rent, gas, electricity, council tax and food for two. Except of course, it isn’t covering food, which is why they’re here at the food bank.

They’re worried their gas and electricity are about to run out. That would leave them in a cold house, unable to heat up some of the tins of food we’re giving them. Our food bank manager Alan rang their energy supplier Utilita, which calls itself “the UK’s leading prepayment gas and electricity supplier”. He said they weren’t very interested in helping. “The couple had recently switched suppliers and this supplier (Utilita) did not seem to understand its responsibility to help vulnerable people and in any case could not act until their smart meter was installed.”

He added that in stark contrast, he contacted energy provider EDF the same day on behalf of another client, and they quickly agreed to provide an emergency supply of gas and electricity – £20 in each case. A bit of welcome good news. Well done EDF.

Getting help from the state seems to be getting harder and harder. Sue says that when they went to the job centre to use the phones, only one phone was left for clients to use. There used to be six lines available. The pair walked miles from their home to the job centre only to find they were unable to get help.

For Peter and Sue, life is very tough at the moment. Peter says they have both been “hungry the last week or two”. This is a particularly worrying development for someone who may be in the first three months of pregnancy. Life is a daily battle for survival. Peter says the key person who helps them is a local vicar. He’s the one who gave them a voucher for the food bank. “He’s understanding and he looks after us. He hates the government like I do. We are just oiks to them. If we get one less payment then the government saves a bit of money.”

The anger expressed by Peter’s vicar is being writ large across the nation. The open letter published in the Daily Mirror last week signed by 27 Anglican bishops is scathing about the Coalition’s “cutbacks to and failures in the benefit system” that have left half a million people visiting food banks since last Easter. It also says that 5,500 people were admitted to hospital in the UK with malnutrition last year. Peter and Sue are in danger of being included in this year’s malnutrition statistics.